Korzets Z, Golan E, Manor Y, Schneider M, Bernheim J
Department of Nephrology, Meir General Hospital, Kfar Saba, Israel.
Clin Nephrol. 1992 Sep;38(3):125-7.
A 35-year-old women was diagnosed as suffering from Hodgkin's disease, lymphocytic predominant, based on a biopsy of an enlarged axillary lymph node. She was classified as stage IIA. Subtotal nodal irradiation resulted in a full remission. Ten months later she presented with a full blown nephrotic syndrome. Renal biopsy disclosed minimal change nephropathy. Despite extensive investigation no evidence of a relapse of the lymphoma was found. Whilst undergoing the investigation her proteinuria began to decrease and during the next 5 months it totally disappeared with no specific treatment being administered. Fourteen months after complete cessation of the proteinuria a left parasternal mass appeared. Biopsy confirmed a relapse of Hodgkin's lymphoma. The patient fully responded to chemotherapy and local irradiation. Noticeably, during the relapse and currently after a 3.5 year follow up period the patient has remained free of proteinuria. A review of the literature yielded altogether 14 cases in which the course of minimal change nephropathy did not run in parallel to that of the lymphoma. These are discussed in detail.
一名35岁女性因腋窝淋巴结肿大活检确诊为淋巴细胞为主型霍奇金病，分期为IIA期。次全淋巴结照射后完全缓解。10个月后，她出现了典型的肾病综合征。肾活检显示为微小病变性肾病。尽管进行了广泛检查，但未发现淋巴瘤复发的证据。在检查过程中，她的蛋白尿开始减少，在接下来的5个月里，未经特殊治疗蛋白尿完全消失。蛋白尿完全消失14个月后，左胸骨旁出现肿块。活检证实霍奇金淋巴瘤复发。患者对化疗和局部照射反应良好。值得注意的是，在复发期间以及目前3.5年的随访期后，患者一直没有蛋白尿。文献综述共发现14例微小病变性肾病病程与淋巴瘤病程不平行的病例，并对其进行了详细讨论。
